Published in:
Open Access
04-03-2022 | Dementia | Original Article
Accuracy of the clinical diagnosis of dementia with Lewy bodies (DLB) among the Italian Dementia Centers: a study by the Italian DLB study group (DLB-SINdem)
Authors:
Mirella Russo, Claudia Carrarini, Angelo Di Iorio, Raffaello Pellegrino, Amalia Cecilia Bruni, Salvatore Caratozzolo, Annalisa Chiari, Stefano Pretta, Camillo Marra, Maria Sofia Cotelli, Andrea Arighi, Giorgio G. Fumagalli, Tatiana Cataruzza, Francesca Caso, Cristina Paci, Mara Rosso, Serena Amici, David Giannandrea, Andrea Pilotto, Simona Luzzi, Annalisa Castellano, Fabrizia D’antonio, Antonina Luca, Giorgio Gelosa, Tommaso Piccoli, Marco Mauri, Federica Agosta, Claudio Babiloni, Barbara Borroni, Marco Bozzali, Massimo Filippi, Daniela Galimberti, Roberto Monastero, Cristina Muscio, Lucilla Parnetti, Daniela Perani, Laura Serra, Vincenzo Silani, Pietro Tiraboschi, Annachiara Cagnin, Alessandro Padovani, Laura Bonanni, on Behalf of the Italian Dementia with Lewy bodies Study Group (DLB-SINdem)
Published in:
Neurological Sciences
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Issue 7/2022
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Abstract
Introduction
Dementia with Lewy bodies (DLB) may represent a diagnostic challenge, since its clinical picture overlaps with other dementia. Two toolkits have been developed to aid the clinician to diagnose DLB: the Lewy Body Composite Risk Score (LBCRS) and the Assessment Toolkit for DLB (AT-DLB). We aim to evaluate the reliability of these two questionnaires, and their ability to enhance the interpretation of the international consensus diagnostic criteria.
Methods
LBCRS and AT-DLB were distributed to 135 Italian Neurological Centers for Cognitive Decline and Dementia (CDCDs), with the indication to administer them to all patients with dementia referred within the subsequent 3 months. We asked to subsequently apply consensus criteria for DLB diagnosis, to validate the diagnostic accuracy of the two toolkits.
Results
A total of 23 Centers joined the study; 1854 patients were enrolled. We found a prevalence of possible or probable DLB of 13% each (26% total), according to the consensus criteria. LBCRS toolkit showed good reliability, with a Cronbach alpha of 0.77, stable even after removing variables from the construct. AT-DLB toolkit Cronbach alpha was 0.52 and, after the subtraction of the “cognitive fluctuation” criterion, was only 0.31. Accuracy, sensitivity, and specificity were higher for LBCRS vs. AT-DLB. However, when simultaneously considered in the logistic models, AT-DLB showed a better performance (p < 0.001). Overall, the concordance between LBCRS positive and AT-DLB possible/probable was of 78.02%
Conclusions
In a clinical setting, the LBCRS and AT-DLB questionnaires have good accuracy for DLB diagnosis.